IBM Health Plan Data Model

IBM Health Plan Data Model

IBM® Health Plan Data Model is an industry-specific blueprint that provides data warehouse design models, business terminology and analysis templates. The software can deliver comprehensive health analytics and business insight to improve the cost, quality and experience of healthcare.

The solution provides updated clinical, technical and industry measures content. It enables your organization to better understand your members, groups, providers and networks. With this insight, you can improve the handling of claims and client health management.

The IBM Health Plan Data Model also supports the Health Insurance Portability and Accountability Act (HIPAA) 5010 specification, and provides published updates to the National Committee For Quality Assurance (NCQA) Healthcare Effectiveness and Data Information Set (HEDIS) standard.

IBM Health Plan Data Model provides features and benefits that help enable:

Risk and compliance reporting: Provides reporting to help you meet a broad range of regulatory requirements.

Data governance and standardization: Allows you to define a corporate set of standard definitions and best practices related to your data. IT can then use data integration, business integration and master data management to enforce standards as well as use data profiling techniques for compliance monitoring and exception alerting.

An enterprise architecture: Provides structure and content to support the business and application layers of an enterprise architecture. Helps you create an analytical data store that connects to your critical data, across disparate systems and formats.

IBM Health Plan Data Model Resources

IBM® Health Plan Data Model version 8.6 delivers new regulatory and business content, clinical measures and outcomes, and support for compliance reporting and management. The latest release also helps lower total cost of ownership through integrated offerings that include tooling such as IBM InfoSphere Data Architect. It further integrates with other hardware and software platforms, including IBM PureData System for Analytics, that help simplify implementation and maintenance.

The latest version of IBM Health Plan Data Model provides these features and benefits:

Enhanced HEDIS support, including HEDIS Volume 2 updates to the latest version of standard 2014.